{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:46:10Z","timestamp":1785415570380,"version":"3.56.0"},"reference-count":37,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2021S1A5A2A03069917"],"award-info":[{"award-number":["2021S1A5A2A03069917"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"award":["2021S1A5A2A03069917"],"award-info":[{"award-number":["2021S1A5A2A03069917"]}],"id":[{"id":"https:\/\/ror.org\/013aysd81","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Exercise-induced hypertension (EIH) has been linked to unfavorable cardiovascular outcomes; however, its implications for cardiac structure and function in middle-aged endurance athletes remain unclear. In the present study, cardiac remodeling was assessed using echocardiographic indicators, including left atrial diameter (LAD), left ventricular wall thickness, left ventricular mass (LVM), left ventricular mass index (LVMI), and the E\/E\u2032 ratio. This cross-sectional investigation examined 73 male long-distance runners aged 40\u201365 years, defined as individuals with \u22655 years of running experience and regular endurance training, classified according to maximal systolic blood pressure (SBPmax) during graded exercise testing: an exercise-induced hypertension group (EIHg; n = 35) and a non-EIH group (NEIHg; n = 38). Compared with the NEIHg, runners in the EIHg exhibited greater LAD, wall thickness, LVM, and LVMI (p &lt; 0.05), whereas systolic function did not differ between groups. The E\/E\u2032 ratio was higher in the EIHg, suggesting subclinical alterations in diastolic function. LAD correlated with SBPmax, maximal diastolic blood pressure (DBPmax), LVM, and LVMI, while LVMI correlated with SBPmax but not resting systolic blood pressure. E\/E\u2032 was associated with DBPmax, LVM, and LVMI. Exploratory multivariable regression analysis showed that peak exercise systolic blood pressure remained associated with LVMI, whereas LAD was associated with SBPmax, BMI, and VO2max. These findings suggest that exaggerated exercise blood pressure responses are associated with cardiac remodeling and early diastolic alterations in middle-aged endurance runners. However, causal relationships cannot be established due to the cross-sectional design.<\/jats:p>","DOI":"10.3390\/life16050853","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:42:18Z","timestamp":1779691338000},"page":"853","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exercise-Induced Hypertension Is Associated with Cardiac Remodeling in Middle-Aged Male Long-Distance Runners: A Cross-Sectional Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9379-656X","authenticated-orcid":false,"given":"Young-Joo","family":"Kim","sequence":"first","affiliation":[{"name":"School of Sports Science, Sungshin Women\u2019s University, Seoul 02844, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0651-2130","authenticated-orcid":false,"given":"Han-Soo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Korean National Sport University, Seoul 05541, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Hyun","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Sanggye Paik Hospital, Seoul 01757, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Eun","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Sungshin Women\u2019s University, Seoul 02844, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Hee","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Exercise Therapy, Gachon University, Seoul 13120, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongbum","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Sanggye Paik Hospital, Inje University, Seoul 01757, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Ho","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Korean National Sport University, Seoul 05541, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7001-7956","authenticated-orcid":false,"given":"Mu-Yeop","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Sports Rehabilitation, Korea Nazarene University, Cheonan 31172, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1874","DOI":"10.1093\/eurheartj\/ehad170","article-title":"Exercise benefits in cardiovascular diseases: From mechanisms to clinical implementation","volume":"44","author":"Valenzuela","year":"2023","journal-title":"Eur. 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